1 / 30

Pediatric Assessment & Communication with the Pediatric Patient

Pediatric Assessment & Communication with the Pediatric Patient. Presented by Marlene Meador RN, MSN, CNE. Therapeutic Communication. How does a nurse communicate with a patient who does not use words? Physical Proximity and environment Touch Listening Visual Communication

Download Presentation

Pediatric Assessment & Communication with the Pediatric Patient

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Pediatric Assessment&Communication with the Pediatric Patient Presented by Marlene Meador RN, MSN, CNE

  2. Therapeutic Communication How does a nurse communicate with a patient who does not use words? Physical Proximity and environment Touch Listening Visual Communication Tone of Voice Body Language Timing

  3. Considerations and strategies for cooperation: Remember developmental age (why is this crucial to success?) p 60 & 61 table 4.3 • Honesty • Involve child- speak directly to the child • Involve parents when appropriate

  4. Developmental milestones and approach to communication

  5. Barriers to Communication • Language • Cultural differences • Distraction • Stress/conflict

  6. Quick Question? • What is the best way to ruin the relationship between the nurse and child/family/patient?

  7. How is the assessment of a child different than the assessment ofan adult?

  8. Adapting the physical assessment to children: • Physical proximity to the child/patient • Physical contact • Sequence of assessment

  9. Examination of Infants • Allow parents to hold and participate • Auscultate when quite • Warm equipment • Invasive procedures last • Rectal temperatures • Lab draws)

  10. Examination of Toddlers • Encourage parents to participate • Introduce equipment • Play • Choices/control • Security object

  11. Examination of Pre-School Age • Demonstrate and introduce equipment • Sequence • Games and play • Distraction

  12. Examination of School Age and Adolescent • Provide privacy (parental presence or absence/chaperone) • Choices of exam sequence • Explanation of body parts and functions • Reassurance of normalcy

  13. Beginning the Examination • Verify patient- National Patient Safety Goal • Introduce self- explain purpose of assessment • Utilize therapeutic communication (open-ended questions) • Address the child (direct questions, make eye contact- WHY?) • Obtain feedback from parents when necessary

  14. Why is an accurate history the single most important component of the physical examination? Page 807 Box 33-3 • Substantive data • Objective data

  15. Three types of health history • Complete or initial • Conception to current status • Well or interim • Previous well visit to current visit • Problem-oriented or episodic • Information related to current problem

  16. Obtaining a history: • Open-ended questioning • Re-phrase rather than repeat • Listen actively (reflective reply) • Cultural differences • Avoid judgmental questions • Psychosocial data is critical to health promotion

  17. Problem-Oriented History Characteristics Defining Variables • Chief complaint and onset • Body Location • Quality • Quantity • Aggravating and alleviating • Previous & current treatment • Use the child’s own words to describe when & how began • Anatomic location general or localized • Burning/stabbing/dull/aching • Intensity of pain or problem • What increases or relieves the pain or problem • Medications, thermo therapy, responses to treatment

  18. Obtaining a Health History • Birth History • Prenatal care (onset and duration) • Mother’s age and health at time of birth • Mother’s history of illness, injuries • Mother’s impression of pregnancy (also significant other’s impression)

  19. Obtaining a Health History cont… • Familial or Inherited Disorders • Chromosomal disorders in other family members • Height and weight • Diabetes • Cardiovascular disease • Asthma/ reactive airway disease • Allergies

  20. Prioritizing Care • Primary- ABCDE’s • Airway, breathing, circulation, LOC (disability, & exposure) • A temperature too low is as serious as too high

  21. Adaptations in Emergency Assessment • S- signs and symptoms • A-allergies • M-medications and immunizations (OTC and herbal) • P- prior illness or injury • L- last meal and eating habits • E- events surrounding illness/injury

  22. Prioritizing Care cont… • Secondary • VS, pain, history and head-to-toe assessment and inspection • Height/weight, diagnostic testing • Psychological problems • Risk of infection • Nutritional problems

  23. Prioritizing Care cont… • Tertiary • Health concerns that do no immedicately threaten the physiologic status of the child: • Knowledge deficit / Patient teaching • Coping • Health maintenance • Activity • Rest

  24. Assessment Findings: head to toe (chapter 33) • Head (eyes, ears, hair, shape, FOC) • Chest- cardiac, respiratory, excursion- shape • Abdomen- size, shape, tone • Musculoskeletal- posture, tone, symmetry • Neuro- reflexes • Skin- including hair • Genitalia- age appropriate

  25. Quick Review: • Why is it important for the nurse to know the normal range of vital signs specific to the age of patients? Table 33-1 page 808

  26. How does the nurse prioritize assessment findings? • Stay alert to what would cause harm… • Is this an acute need? Or at risk for? • How does the nurse select the intervention? • How do you evaluate the effectiveness of the intervention?

  27. What physical and psychosocial findings suggest abuse or neglect? • Dress • Grooming and personal hygiene • Posture and movements • Body image • Speech and communication • Facial characteristics and expressions • Psychological state

  28. When would the nurse notify CPS? • What are the nurse’s legal obligations • What are the nurse’s ethical obligations?

  29. Recognize your own limitations and protect yourself. The Health Science Programs of Austin Community College recognize the additional stressors associated with becoming a nurse. We offer free counseling services to all students through the Student Services Department These counselors offer confidential assistance to any student as well as test taking skills and tips EVC- Sandra Elizondo (512) 223-5810 selizond@austincc.edu RRC- Julie Reck (512) 223-0235 jcuellar@austincc.edu

  30. Please contact Marlene Meador RN, MSN if you have any questions or concerns regarding this information. Mmeador@austincc.edu 512-422-8749

More Related